Three ingredients have shouldered much of the blame for the nation’s growing health woes. But is the finger-pointing justified?

[2][3][4][5]

thinkstock

Dr. Ruth Kava isn’t concerned with the hype or hyperbole, emotion or ideology. She’s after one result: scientific accuracy.

A senior nutrition fellow with the American Council on Science and Health (ACSH), a New York–based organization that highlights peer-reviewed science to encourage more sensible public health policy, Kava has watched the rising vitriol against trans fat, high fructose corn syrup (HFCS), and sodium in recent years. She fears the finger-pointing is overshadowing important facts.

“It’s too simplistic to call any of these components all good or bad. They each have their practical uses, as well as their negatives; that’s the reality,” Kava says.

That reality hasn’t stopped many critics, scientists, and other experts from railing against the three ingredients for contributing to rising obesity rates, cardiovascular disease, and other detrimental health issues. And in recent years, legislators and health advocates have taken each of these dietary components to task. New York City and California are among the many governments to ban trans fat; HFCS, once labeled “the Devil’s candy,” has been the subject of online petitions calling for its elimination; and sodium-reduction legislation has gained traction in various municipalities across the country.

The mounting attention has prompted action from many quick serves. Jason’s Deli rolled out its trans fat–free menu in 2005, eight years after it first began questioning the ingredient’s validity.

“We realized that trans fat was essentially worthless, though ubiquitous,” says Pat Herring, director of research and development at Jason’s Deli. As soon as Jason’s Deli eliminated trans fats, it addressed HFCS. The chain, which now has about 250 units, began a two-year process of swapping HFCS for ingredients such as cane sugar and honey, an endeavor completed in 2008. Jason’s Deli has also tackled sodium reduction, a self-imposed journey that Herring says was a challenge.

“We’re a deli with pickles and sauerkraut and corned beef, so it’s been a slow, incremental process [to reduce sodium], because we don’t want to hurt the inherent flavor of food,” he says.

Sparked by New York City’s 2006 trans-fat ban, Boston Market reduced trans fat in its pie crust, chocolate cake, cornbread, poultry gravy, and meatloaf. Last August, the nearly 500-unit quick serve removed salt shakers from its tables and pledged to reduce menu-wide sodium levels by 15 percent by the end of 2014. “We keep a close watch on changing consumer needs overall and specifically as it relates to health concerns. When we feel that our food may not be delivering on our purpose, we re-evaluate,” says Boston Market chief brand officer Sara Bittorf.

Anita Jones-Mueller, CEO and founder of Healthy Dining Finder, an online database for health and nutrition, applauds the swelling industry movement. She calls trans fat, HFCS, and sodium “unacceptable for our health,” and hopes restaurants continue to reformulate menu items and add new offerings with a greater emphasis on health and balance.

While Kava, too, champions health and balance, she remains laser-focused on accurate and credible scientific data. She paints the claims against HFCS as a case of hype and headlines—along with a marketing punch—that are overtaking science.

The conversation surrounding links between HFCS and obesity began in 2004, when three researchers released a widely cited paper in The American Journal of Clinical Nutrition titled “Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity.”

“It was noted as an interesting correlation and one worthy of further exploration,” Kava says.

But some charged forward in an anti-HFCS push. HFCS was quickly blamed for the nation’s expanding waistlines and, subsequently, the rising rates of diabetes and cardiovascular disease. “There’s no reason to say that because two things happened at the same time that one happened because of the other,” Kava says.

Kava, in fact, says HFCS is no different than the refined white sugar it replaces, but that it remains an easy target because of its prevalence. “Picking out specific ingredients is not a smart way to go,” she says.

Dr. Walter Willett, chair of the department of nutrition at Harvard University’s School of Public Health, shares a similar viewpoint. He says the focus on HFCS is off target. “HFCS is an issue, but the real culprit here is sugar,” he says. Slowly, the argument is indeed being rephrased from the detriments of HFCS to, more accurately and broadly defined, sugar.

“Saying high fructose corn syrup causes obesity is like saying the fork makes you fat,” says Jessica Begy, a dietitian with U.S. Foods, which has released products with no HFCS. “Sugar is sugar, and that needs to be the target.”

Trans fat, meanwhile, has been connected to cardiovascular disease and diabetes, with charges that it creates adverse effects on cholesterol and metabolism. “Trans fat is toxic to human metabolism, and there’s no reason for it to be present,” Willett says.

Kava and her ACSH colleague, Dr. Elizabeth Whelan, have questioned that widespread opinion. While far from trans-fat proponents, the pair have argued repeatedly that trans-fat calorie counts are no higher than other fats. Regulators, they say, have offered up trans-fat bans as a knee-jerk remedy to the multilayered obesity issue.

“Trans fat is not necessary in food, but it’s not a toxin, either. It’s a lab-produced product that has its practical uses,” Kava says.

Again, she adds, marketing has overpowered mindfulness. Restaurants have promoted trans fat-–free offerings and cities have celebrated trans-fat bans without a clear idea of the component’s real dangers, she says, or of the dangers that arise from trans-fat substitutes, such as interesterified fats.

“Marketing ‘No HFCS’ or ‘Trans Fat Free’ will play to consumers who have an unwarranted viewpoint,” Kava says. “As we sit here today, the scientific truth is far more complex than simply banning trans fat as the cure-all.”

As for sodium, a naturally present ingredient that has been linked to high blood pressure and cardiovascular disease, the issue for many is not in eliminating sodium, but offering balance. “Sodium levels can’t be zero and shouldn’t be,” Willett says.

With all three dietary components, Kava says, many restaurant brands and regulators have jumped on a bandwagon that, while holding its merits, might unreasonably target precise ingredients.

“When you say a product lacks any of these three components, it can make peoples’ ears perk, but that’s not necessarily an indicator that the food is particularly healthful or nutritious,” Kava says. “There’s more at play here.”

Indeed, despite more than a decade of discussion, research, and mounting attention, the truth regarding trans fat, HFCS, and sodium is not as clear as many would like. Each of the dietary components continues to have its supporters and opponents, at once considered both a vice and a miscast target of the nation’s collective health woes. While few will champion the dietary factors as “healthy,” particularly in more-than-necessary amounts, the debate intensifies over each component’s potential detriment.

Quick-serve operators have been left to figure out what to do with their own menus. But experts interviewed for this story say the path forward is clear: Abide by the regulators who demand compliance and the customers who demand consistent quality.

Willett says regulations need not be viewed with such derision. In fact, he contends that set guidelines can help businesses succeed and meet diners’ best interests. “For even the most well-intentioned companies, it can be difficult to do the right thing when competitors are not,” he says. “Regulations can create a level playing field.”

Willett hopes, however, that restaurants will take a more proactive approach before regulations force marketplace action. He considers the industry’s increasing attention to trans fat as a positive sign that restaurants desire healthier offerings.

Health crusaders further charge that restaurants’ attentiveness to these dietary factors represents a matter of social responsibility. “There’s a lot of power in looking at menu ingredients and sub-recipes to gauge the negative nutrients and rebalance,” Healthy Dining Finder’s Jones-Mueller says. “With greater menu transparency, restaurants are in the driver’s seat to create change.”

Voting with their dollars, consumers will likely hold an even greater voice than rule-happy regulators.

“Internal discussions [among restaurant leaders] should be around what’s most important for the restaurant to provide healthful food for its guests,” Kava says. “If lowering certain components is what your consumers want, then it’s simply a good play to respond.”

Boston Market’s Bittorf says that while consumers have become more informed, quick-service restaurants also have better tools to monitor consumer insights and decide how to adapt.

“Boston Market has continued to remain competitive by listening to what our customers want and don’t want, from menu items to ingredients,” Bittorf says.

Many advocates argue that restaurants need little more than a proactive mindset and motivated investment to create healthier, cleaner food that retains its flavor. In an audit of Harvard Dining, Willett and colleagues found that sodium levels could be decreased by 25 percent with what he calls “little effort.”

“I hope as an industry we can show that restaurants have a desire to creae and offer healthy, appealing menu items,” Jones-Mueller says.

While Subway openly shares its nutritional numbers both in store and on its website; cut sodium across its menu by 15 percent; and removed trans fats from baked goods, the sandwich chain has not actively promoted its reformulations.

“The changes we make need to be invisible to the consumer,” says Subway director of marketing development Michelle Cordial. “The minute you tell someone the product’s healthy, they often assume that means less tasty, and we’ve worked for years to be a concept that provides better-for-you products high in flavor.”

A pragmatist, Herring admits distinguishing fact from fiction in the trans fat, HFCS, and sodium conversation has become increasingly difficult to navigate given its complexity and the range of conflicting opinions. At Jason’s Deli, he says, the company’s task is not to run food labs, but to be responsible, customer-pleasing operators.

“We’re not food scientists, but food people,” Herring says. “Ultimately, we believe in balance and, to us, that seems the safest way to go.”